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November 10, 1923


JAMA. 1923;81(19):1627. doi:10.1001/jama.1923.02650190057032

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To the Editor:  —In the discussion of Dr. Hunt's paper on epidemic (lethargic) encephalitis (The Journal, October 20), Dr. D. H. Morgan described an unusual case of postencephalitic manifestations. Dr. Hunt stated that he had seen none such and no explanation was offered. I have seen several similar although no identical symptoms, and submit an explanation.Encephalitis, like other organic processes, often permits previously silent constituents of the unconscious to be revealed. Delirium with acute somatic illness often contains elements which seem meaningless and unintelligible, but which may be found on analysis to be largely comprehensible. An example of this occurring in uremia will shortly appear in the Journal of Nervous and Mental Diseases. The same phenomenon in general paralysis and other undoubted brain diseases has been described. In Dr. Morgan's case, encephalitis was the organic process. The symptom described, however, was obviously one on the psychologic (rather than the

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